ORDER

BY SRI.H.R.SRINIVAS, PRESIDENT.

1.     This is the Complaint filed by the Complainant U/S Section 12 of Consumer Protection Act 1986, against the Opposite Party (herein referred in short as O.P) alleging the deficiency in service and to calculate the interest with cumulative effect @ 8% per annum from the date of issuance of the policy till the date of maturity of the amount and to pay Rs.3,12,233/- to the complainant along with interest and cost and other reliefs as this forum deems fit under circumstances of this complaint.

2.     The brief facts of the complaint are that: Complainant had obtained SBI Insurance Policy No.35012402706, from OP on 03.08.2011 and the policy period was for a period of five years from the said date with the assurance that he will get return of minimum of Rs.2,50,000/-.  Further the complainant paid premium amount of Rs.49,811/- with service tax and education cess in all Rs.2,49,055/- for the said period.  The maturity date of the policy is 20.06.2016. OP  sent the letter to complainant that the policy is matured on 30.07.2016 and paid Rs.1,85,889 after deducting TDS of Rs.1,878/- to the complainant. On the other hand, he is entitle to more amount then he has invested. The conditions laid down in the policy are unilateral one and cannot impose on the complainant.  He was promised at the time of issuing the policy that he would get Rs.2,50,000/- after period of five years (Policy period).  He was expecting more than what he has invested at the time of maturity and hence there is deficiency in service on the part of OP in not paying the assured and promised amount and misleading the customers and investors.   He is entitle for balance amount of Rs.1,57,705/- apart from what has been paid to him.  In addition to it, he is also entitle for Rs.1,54,528/- as promised by OP at the time of issuing the policy and cause of action of the complaint arose on 30.10.2016 when he  issued legal notice demanding OP to pay the amount along with interest cumulatively at 8% per annum and also on 11.11.2016 when the OP has given as untenable reply to the notice and hence the complaint.

3.     Upon the service of the notice, OP appeared before the forum through its advocate and filed version admitting issue of policy to the complainant and as per the proposal form signed by the complainant and as per the terms and conditions of the policy issued, the maturity value of the policy was paid to the complainant.  The complainant is also entitle for basic sum assured on his attaining age of 100 years as per the terms and conditions of the policy. Hence there is no deficiency in service on its part. As per the IRDA Rules and Regulations, OP has acted and hence the same cannot be termed as deficiency in service.  It has acted strictly under the policy conditions and hence there is no mala-fide intention or abuse of process of law.   The complaint is barred by limitation under Section 24-A of Consumer Protection Act as the policy was issued in the year 2011 and the complaint is filed after a gap of six years.

4.     There is no jurisdiction under Section 11 of Act to entertain and decide the complaint.   In the proposal form under Form No.17, the complainant has given a declaration regarding that he has not provided any false information. Under part No.3 of the terms and conditions of the policy and Clause No.13,there is free look period  for a period of 15 days from the date of receipt of the policy document to review the terms and condition and where the proposer disagree of any of the terms and conditions he/she has option to return the policy.  As per Part II of the policy survival benefits i.e. basic sum assured along with vested simple reversionary bonus if any shall be payable at endowment maturity date and on the endowment assurance with whole life maturity date an additional amount equal to the basic sum assured will be paid.   The endowment maturity date defined in part (1) is the date on which basic sum assured plus vested bonus becomes payable if the life assured is alive on the said date and endowment assurance with whole life maturity date is the date  of policy anniversary immediately following the date on which the assured completes 100 years of age.

5.     As per the policy conditions, the maturity date was 30.07.2016 and hence they released the amount  with survival benefits on maturity.   The tentative amount was calculated on 10.06.2016 and a sum of Rs.1,85,889/- was given after calculating exactly the amount due to the complainant. Apart from this, complainant is also entitle for the basis sum assured till the life assured completes 100 years of age.  When such being the case, there is no deficiency in service and further prayed the forum to dismiss the complaint by denying all the allegations made in each and every paras of the complaint.

6.     In order to prove the case, both the parties filed their affidavit evidence and produced documents. Arguments Heard.The following points arise for our consideration:-

1) Whether the complainant has proved

    deficiency in service on the part of the

    Opposite Parties?

2)  Whether the complainant is entitled to

     the relief prayed for in the complaint?

7.     Our answers to the above points are:-

POINT NO.1 & 2:     In the Negative

                                For the following.

REASONS

POINT No.1 & 2:-

8.     It is not in dispute that,the complainant is a policy holder issued by OP. It is nomenclatured as SBI Life – Shub Nivesh and it is a endowment policy.  The premium and the period for which the premium to be paid is mentioned.  It is also mentioned in Part-II as to  what are all the benefits the complainant is entitle during his life time under endowment assurance and also under endowment assurance with whole life option which is self-explanatory.

 9.     It is not in dispute that after completion of the policy premium payable period, the complainant has been paid Rs.1,87,767/-.  Probably by mistake the complainant has filed this complaint fearing that though he has paid more amount towards the premium, he has been given less amount.  On the other hand, the terms and conditions of the policy is clear that after the initial period of premium paid period, i.e. endowment assurance, he was given basic sum assured along with vested simple reversionary bonus, whereas, under endowment assurance with whole life option, he is also entitle for basic sum assured with vested simple reversionary bonus after the endowment maturity date i.e. after he attained 100 years.

 10.   It cannot be said now that, the terms and conditions are unilateral one and cannot be imposed on him and no purpose would be served by taking  such a policy to receive less amount than what has been invested and it amounts to void contract.

 11.  It is the bounden duty of the complainant to go through the terms and conditions of the policy for which a look out period has been provided and complainant could have gone through the terms and conditions of the insurance policy after receiving the same and should have opted out in respect of this policy if he was not agreeable for the said terms and conditions and the said terms and conditions are detrimental to his interest. He has not exercised his right of look out period.  He could have refused to continue the policy.  He has not done so.

  12.    On perusing the entire documentary and oral evidence, we are of the opinion there is no deficiency in service or unfair trade practice on behalf of OP. Hence we answer POINT NO.1 AND 2 IN THE NEGATIVE.           

13.   Complainant being an Ex-Central Government employee working in the Income Tax department ought to have known the terms and conditions of the policy and then only ought to have filed this complaint.  Had he gone through the terms and conditions of the policy and his proposal, he would not have ventured to file this complaint. Filing of this complaint made the OP to defend itself by engaging advocate by paying his professional fee and spending time and energy in attending the forum. Hence we are of the opinion that if a sum of Rs.10,000/- towards litigation expenses if ordered to be paid by the complainant to Op would meet the ends of justice under the circumstances of the complaint. Hence we pass the following:-

ORDER

1. The Complaint is dismissed with cost.
2. The Complainant is hereby directed to pay a sum of Rs.10,000/- to the OP towards cost and litigation expenses.
3. The Complainant is hereby directed to comply the above order at within 30 days from the date of receipt of this order and submit the compliance report to this forum within 15 days thereafter.
4. Send a copy of this order to both parties free of cost.

Note:You are hereby directed to take back the extra copies of the Complaints/version, documents and records filed by you within one month from the date of receipt of this order failing which the same will be destroyed as per the C.P. Act and Rules thereon.

(Dictated to the Stenographer over the computer, typed by him, corrected and then pronounced by us in the Open Forum on this 25^thAPRIL 2019)

ANNEXURES

1. Witness examined on behalf of the Complainant/s by way of affidavit:

Copies of Documents produced on behalf of Complainant/s:

Ex C1: Copy of Insurance Policy.

Ex C2 & 3: Letter Written by Complainant (2 Nos)

Ex C4: Copy of the legal notice.

Ex C5: Copy of Reply  sent by OP.

2. Witness examined on behalf of the Opposite party/s by way of affidavit:

RW-1: Ms.Dhanya.K.P., Authorized Representative of OP.

RW-2: Ms.Jigyasa Shreyans, Head – Customer Relationship and customer Engagement of OP.

Copies of Documents produced on behalf of Opposite Party/s

Ex R1: Copy of the Policy.

Ex R2: Copy of Policy document with conditions.

Ex R3: Copy of letter dated 10.06.2016.

Ex R4: Copy of maturity  payment letter dated 09.08.2016.

Ex R5: Copy of the Legal notice.

Ex R6: Copy of the Reply given by OP.

MEMBER                        PRESIDENT

A*